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Abstract

Objective: To examine the association between gestational age at birth and hospital admission costs from birth to 8 years of age.

Design: Population-based, record linkage, cohort study in England.

Setting: National Health Service (NHS) hospitals in England, UK.

Participants: 1 018 136 live, singleton births in NHS hospitals in England between 1 January 2005 and 31 December 2006.

Main outcome measures: Hospital admission costs from birth to age 8 years, estimated by gestational age at birth (<28, 28–29, 30–31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41 and 42 weeks).

Results: Both birth admission and subsequent admission hospital costs decreased with increasing gestational age at birth. Differences in hospital admission costs between gestational age groups diminished with increasing age, particularly after the first 2 years following birth. Children born extremely preterm (<28 weeks) and very preterm (28–31 weeks) still had higher average hospital admission costs (£699 (95% CI £419 to £919) for <28 weeks; £434 (95% CI £305 to £563) for 28–31 weeks) during the eighth year of life compared with children born at 40 weeks (£109, 95% CI £104 to £114). Children born extremely preterm had the highest 8-year cumulative hospital admission costs per child (£80 559 (95% CI £79 238 to £82 019)), a large proportion of which was incurred during the first year after birth (£71 997 (95% CI £70 866 to £73 097)).

Conclusions: The association between gestational age at birth and hospital admission costs persists into mid-childhood. The study results provide a useful costing resource for future economic evaluations focusing on preventive and treatment strategies for babies born preterm.

Data availability statement
Data may be obtained from a third party and are not publicly available. The authors do not have permission to supply data or identifiable information to third parties, including other researchers, but the team at City, University of London has permission under regulation 5 of the Health Service (control of patient information) Regulations 2002 to analyse patient identifiable data for England and Wales without consent and create a research database that could be accessed by other researchers using the SRS at the ONS. The TIGAR team has permission under regulation 5 of the Health Service (control of patient information) Regulations 2002 to analyse these data. Anyone wishing to access the linked datasets for research purposes should apply via the CAG to the Health Research Authority to access patient identifiable data without consent and then to the ONS and NHS Digital. In the first instance, enquiries about access to the data should be addressed to Alison Macfarlane.

Publication Type:	Article
Subjects:	G Geography. Anthropology. Recreation > GF Human ecology. Anthropogeography H Social Sciences > HC Economic History and Conditions R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments:	School of Health & Psychological Sciences > Midwifery & Radiography
SWORD Depositor:	Symplectic Administrator

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